Uji efektivitas ekstrak kunyit (Curcuma longa) terhadap daya hambat pertumbuhan bakteri Streptococcus mutans

Background: Dental caries is a multifactorial disease characterized by dental tissue damage caused by the production of bacterial acids. The bacteria play the most role in the occurrence of caries is Streptococcus mutans. Turmeric extract (Curcuma longa) has been studied can inhibit bacterial growth because it contains essential oils and curcumin. The purpose of this study was to determine the inhibitory power of turmeric extract 5%, 10%, 20%, and 40% on the growth of Streptococcus mutans bacteria.

Methods: Studies with true experimental design using a post test only control group design have been carried out on Streptococcus mutans bacteria. Turmeric extract was made by maceration method into 96% ethanol so that the required concentration was obtained (5%, 10%, 20%, dan 40%). The inhibition testing is done by the disk-diffusion method. Data were analyzed using the Kruskal-Wallis test on SPSS version 20 due to the data were not normally distributed.

Results: The results showed that phytochemical assessment of turmeric extract showed positive results on phenol, essential oil, saponins, tannins, and flavonoids. The average value of the inhibitory zone diameter of Streptococcus mutans bacteria formed in turmeric extract concentrations of 5%, 10%, 20%, and 40% is 0 mm where there are significant differences compared to positive controls (P < 0.05)

Conclusion: Various doses of turmeric extract couldn’t inhibit the growth of Streptococcus mutans bacteria 

Hubungan antara perubahan iklim dengan jumlah kasus demam dengue (DD) di Denpasar, Bali tahun 2010-2015

Background: Dengue is one of tropical infectious disease that can give a serious public health problem in Denpasar. Several factors have been associated with the high prevalence of dengue fever; one of them is climate changes. This study aims to determine the relations between climate change and a number of dengue cases in Denpasar.

Methods: The climate change and a number of dengue cases data take place in Denpasar from the year 2010-2015 using observational study. The Spearman correlation test was used to know the relation between climate change ( maximum and minimum temperature, rainfall, humidity, light duration, and wind velocity ) and a number of dengue cases. Data were analyzed using SPSS version 20 software for windows.

Results: The highest prevalence of Dengue Fever infection was in 4,431 (38.16%) cases in 2010, followed by 1,837 (15,82%) cases in 2014, 1,766 (15.22%) cases in 2013, 1,576 (13.57%) cases in 2015, 1,009 (8.69%) cases in 2012, and 992 (8.54%) cases in 2011. Based on climate variables, rainfall has a weak significant relation affecting the number of dengue cases compared with others (r=0.247; p=0.036).

Conclusion: Rainfall was the only climates variables significantly related to the high prevalence of dengue fever in Denpasar, Bali since 2010-2015. So, further efforts need to be done to prevent dengue cases on rainy season.

Uji efektivitas ekstrak etanol kulit buah naga merah (Hylocereus polyrhizus) terhadap Staphylococcus aureus ATCC 25923 secara in vitro

Introduction: Infectious diseases are still one of the main causes of high morbidity and mortality in tropical Indonesia. One of the causes of this disease is the staphylococcus aureus bacteria. Red dragon fruit peel contains potentially antibacterial compounds such as flavonoid, alkaloid, saponin, tannin dan terpenoid. The purpose of this study is to determine the antibacterial activity of ethanolic extract of red dragon fruit peel against staphylococcus aureus ATCC 25923.

Method: The method used is true experimental post test only control group design. The activity of ethanol extract of red dragon fruit skin was tested in various concentrations (25%, 50%, 75%, and 100%) against staphylococcus aureus ATCC 25923 by measuring the inhibition zone diameter and minimum inhibitory concentration (MIC).

Result: The results of this study show that red dragon fruit peel ethanolic extract has antibacterial activity against staphylococcus aureus ATCC 25923 ith the average diameter of inhibition zone ranging from 8.25 mm – 12.5 mm. The MIC is obtained at concentration of 25%. Kruskal-Wallis test found a significant comparison with a value of p = 0,000 (p value <0.05). Mann-Whitney test showed that there were significant differences between each concentration, except the concentration of 50% did not have a significant difference with a concentration of 75%.

Conclusion: The minimum inhibitory concentration (MIC) is produced by extract at a concentration of 25% and the best inhibitory zone produced by 100% concentration of red dragon peel ethanol extract.

Gambaran kepuasan pasien rawat jalan terhadap pelayanan kesehatan di UPT Kesmas Payangan, Gianyar, Bali

Background: Health service is any efforts held by personal or together in an organization to maintain and increasing health as well as patient’s satisfaction. This study aims to know the outpatient patients’ satisfaction representation toward health service in UPT Kesmas Payangan.

Methods: A cross-sectional descriptive study was conducted among 85 outpatient at UPT Kesmas Payangan. Sample technique used in this study was convenience sampling method. Samples are outpatient patients who were visiting UPT Kesmas Payangan and assesses using valid and reliable questionnaire regarding patient’s satisfaction based on 5 dimensions (tangible, reliability, responsiveness, assurance, empathy). Data were analyzed using SPSS version 20 for Windows.

Results: Most of outpatient are satisfied at UPT Kesmas Payangan (88.2%). Based on satisfaction dimension, our study found that more patients are satisfied in reliability (82.3%), responsiveness (94.1%), assurance (92,9%), tangibles (84.7%), and empathy (88,2%). In addition, female patients are more satisfied (91,3%) than males (84,6%), following by lower level of education is more satisfied (95,2%) as well as in jobless group (100%) compared with others. According to the method of payment, group that using out of pocket method is more satisfied (90%) than using BPJS health insurance (88%).

Conclusion: Most of outpatients at UPT Kesmas Payangan are satisfied with health services provided particularly in responsiveness dimension. Out of pocket as method of payment is also tend to given higher satisfaction than BPJS health insurance.

Perilaku hand hygiene tenaga kesehatan di RSUP Sanglah tahun 2018

Background: Low hand hygiene behavior is a very detrimental and a cause of health care associated infection and is a problem faced by patients and the medical profession at this time. The purpose of this study was to find out the distribution of hand hygiene behavior among healthcare professionals in Sanglah General Hospital Denpasar.

Method: This study was conducted using a descriptive method with a cross-sectional study design carried out in the polyclinic and inpatients ward at Sanglah General Hospital in September to November 2018.

Results: From the 96 study samples, 82.3% had good compliance with hand hygiene standards and 68.7% had a positive perception of hand hygiene. Women are more obedient than men towards the implementation of hand hygiene and doctors is the lowest profession to have a level of adherence to hand hygiene.

Conclusion: Perception and compliance with hand hygiene in medical personnel at Sanglah General Hospital Denpasar has been very good, but it still needs to be improved so that all medical personnel perform hand hygiene procedures as a routine practice for the sake of infection prevention and control.

Major risk factors that are potential for infertility among male semester 3 and 5 medical students, Faculty of Medicine, Udayana University year 2017

Introduction: A couple being unable to get pregnant result out of unprotected sex and have been trying for one year is defined as the inability to conceive or infertile. Other reasons can be due to the male lifestyle itself, for example obesity, alcohol consumption and also smoking. This study aims to look for various things that might be risk factors for infertility in male students of semester III and V, in the Faculty of Medicine of Udayana University in 2017.

Method: This study used a descriptive cross-sectional design carried out during the 2017 period using the questionnaire given to respondents, a total of 116 male respondents in this study. Identification of lifestyle that can be a risk factor for infertility was assessed in all respondent.

Result: Through this research, it can be known that lifestyle risk factors that cause infertility are using a laptop on the lap for hours (29.3%), injury in groin area (14,%), alcoholism (11.2%), continuous fast food consumption (12.1%), and obesity (6.9%), and active smoker (1.7%). In the other side of the person still doing a sedentary lifestyle and low physical activity.

Conclusion: Sedentary lifestyles with low physical activity are common lifestyle finding among medical students so that this can be a lifestyle that becomes a risk factor for the onset of infertility.

Perbedaan manifestasi klinis dan laboratorium kolestasis intrahepatal dengan ekstrahepatal pada bayi di RSUP Sanglah Denpasar periode Januari 2015 - Desember 2018

Introduction: Physiological jaundice found in infants and most symptoms are often mild. In conjugated jaundice defects in intra-hepatic production, transmembran transport from bile, i.e. cholestasis intrahepatic, or extra-hepatic obstruction/cholestasis occur, resulting in bile barriers. This study was conducted to look at the differences in the clinical and laboratory manifestations of IH and EH cholestasis in infants.

Method: A descriptive retrospective study was performed on 102 infants with cholestasis who came to Sanglah Hospital Denpasar, during the period of January 2015 – December 2018. Data analysis was performed with pearson Chi-square test and independent t-test.

Result: Subjects consisted of 60 infants boys and 42 infant girls, intrahepatic cholestasis were 79 and extra-trahepatic cholestasis were 42. Significant differences in characteristic of nutritional status with intrahepatic and extra-hepatic cholestasis were found (p=0,015), but there isn’t significant differences in age, birth weight, gestational age were observed. On examination of stool color, there was a significant difference (p<0,001), as well as laboratory results of SGOT, SGPT (p<0,05) between intra and extra-hepatic cholestasis. Meanwhile there isn’t significant differences in GGT, total bilirubin, direct bilirubin, indirect bilirubin, and ALP.

Conclusions: There were differences in the characteristics of nutritional status, differences in laboratory results of SGOT, SGPT, and fecal clinics between intrahepatic and extrahepatic cholestasis.

Hipertensi sebagai prediktor kejadian kardiovaskular mayor pada pasien infark miokard akut pada tahun 2018 di RSUP Sanglah Denpasar, Bali-Indonesia

Introduction: Acute Myocardial Infarction (AMI) is a leading cause of morbidity and mortality in developed countries, as well as emerged as a very important health problem in developing countries. Despite of management and treatment of AMI strategies has been evolving. Complications due to AMI cause high morbidity and mortality. To minimalize complications in AMI patients need some risk stratification. Risk stratification have been made based on AMI pathophysiology. Hypertension is a factor that directly influences the development of atherosclerosis through mechanical stress.

Method: This study was a retrospective cohort observational study that enrolled 70 patients with AMI as the subject of research by consecutive sampling from January 2018 – September 2018. Data retrieval is done by taking data from medical records of patients in the Sanglah General Hospital. Outcome observed was in-hospital MACE (cardiovascular death, cardiogenic shock, heart failure, and malignant arrhythmias).

Result: In this study, it was found that hypertension is a predictor of major cardiovascular events by almost 5-fold (HR = 5,02, 95% CI = 1,32-19,20, p = <0.018in patients with AMI that were treated at Sanglah General Hospital.

Conclusion: The conclusion of this study is hypertension is a predictor of major cardiovascular events in patients with AMI on admission to hospital. The results of this study are expected to be used as baseline data for subsequent larger studies.

Korelasi jenis dan lama waktu pemberian obat antituberkulosis paru terhadap kadar glukosa darah di RSUP Sanglah periode 2015-2016

Background: Tuberculosis (TB) is a chronic infectious disease caused by an infection of the Mycobacterium tuberculosis complex. Antituberculosis (OAT) drugs used in TB treatment include Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), Ethambutol (E), and Streptomycin (S). The effects of OAT use are many that are hepatotoxic. This hepatotoxic disrupts liver function as a very important glucose buffer system. The purpose of this study was to determine the correlation of the type and duration of administration of OAT to blood glucose levels at Sanglah Hospital.

Method: This study is an analytical study with a cross sectional study design. The population in this study were tuberculosis patients who were treated at Sanglah General Hospital, Denpasar in March 2015 - October 2016. The selection of samples used consecutive sampling with a total sample of 38.

Results: The correlation test results between the duration of OAT administration and blood glucose levels in tuberculosis patients at Sanglah General Hospital using the spearman test obtained a correlation coefficient (r) value of 0.536 so that according to statistics it can be concluded that there is a positive correlation between the length of time OAT is to blood glucose concentrations. The correlation test between the type of OAT on blood glucose levels in tuberculosis patients in Sanglah General Hospital used the chi-square test obtained P value is 0.133 so according to statistics it can be concluded that there was no significant relationship between the type of OAT to blood glucose concentrations in tuberculosis patients at Sanglah Hospital.

Conclusion: There is a significant positive correlation between the duration of OAT treatment of blood sugar levels, but there is no relationship between the type of OAT to blood sugar levels in patients with pulmonary tuberculosis.

Karakteristik gambaran sitologi pap-smear sebagai tes skrining untuk lesi pra-kanker serviks di RSUP Sanglah, Denpasar, Bali

Background: Cervical cancer is the second most often cancer that occurs in women worldwide after breast cancer and as many as 84% of the cases occur in developing countries. Pap Smear is a screening method that widely used for cervical cancer screening. The aim of the study is to obtain the characteristic data of pap smear cytology as a pre-cervical cancer screening in Sanglah General Hospital 2016 – 2017 period.

Methods: This study was descriptive research with cross sectional study design. The sampling technique is total sampling where the research data comes from the cytology registration book results of the Anatomical Pathology Laboratory at Sanglah General Hospital Denpasar 1 January 2016 - 31 December 2017 period which has fulfilled the inclusion criteria and does not meet the exclusion criteria. Data were analyzed using SPSS version 20 for Windows.

Results: This study collected as many as 590 samples. Most of the pap smear patients at Sanglah General Hospital Denpasar were 41-50 year old group as many as 188 people (31.86%), most of the patients parities were nullipara parities as many as 324 people (54.92%), most had no complaints as many as 261 people (44.24%) and most of the pap smear cytology description was Reactive Cellular Changes Associated with Inflammation (RCCI) as many as 261 people (44.64%).

Conclusion: Most of the respondents who underwent pap-smear test as a screening step for pre-cancerous lesions had a cytological picture of Reactive cellular changes associated with Inflammation (RCCI)

Perbedaan hitung trombosit, Mean Platelet Volume (MPV), dan Platelet Distribution Width (PDW) antara pasien dengan infeksi Helicobacter pylori positif dan negatif di RSUP H. Adam Malik, Medan, Indonesia

Background: H. Pylori cause one of the most common human infections, being present in the gastric mucosa of more than a half of the world population. H. pylori infection can be detected by testing antibodies (IgA and IgG) in serum or saliva. Platelets play an important role in the pathogenesis of abnormalities associated with local or systemic inflammation through the release of thrombotic and inflammatory agents. Mean Platelet Volume (MPV) has long been known as a marker of inflammation and this role has been shown previously in various gastrointestinal disorders. Platelet distribution width (PDW) is a platelet index that reflects variations in platelet size.

Methods: Thirty-two consecutive dyspepsia patient who fulfilled the criteria were included. Platelet levels, MPV, PDW, are promising in each patient. We changed the differences in platelets, MPV, PDW patients, dyspepsia with positif and negatif H. pylori infection. Data were analyzed using SPSS version 20 for windows.

Results: Most of respondents were females (71.9%) and 56±17.45 years old for the average age. The mean of hemoglobin level was 13.47±1.59 g/dL, followed by 11,33±1,71 fL for MPV, 10,7±0,75fL for PDW, and positif H.pylori infection in 56,3% of respondents. There were no differences in platelets, MPV, PDW significantly between the population groups of H. pylori positif and H. pylori negatif (P>0.05)

Conclusion: There were no differences in platelets, MPV, PDW significantly between the population group H. pylori positif and H. pylori negatif.

Karakteristik profil pasien urtikaria akut di poliklinik kulit dan kelamin Rumah Sakit Umum Pusat (RSUP) Sanglah periode Oktober 2017- 2018

Background: Acute urticaria is a skin disorder that is often encountered that can cause redness to respiratory obstruction so that emergency emergencies and urticaria lesions that last more than 72 hours are indicative of hospitalized patients. This study aims to describe the characteristics of acute urticaria at Dermato-Venerology Polyclinic, Sanglah General Hospital during October 2017-2018 period.

Methods: A cross-sectional study was conducted using secondary data from medical records of patients with urticaria in Sanglah General Hospital in the October 2017-2018 period. Data retrieval was taken by the Total Sampling method. Distribution of research variables namely, gender, age, genetic, causative factors, were collected. Data analysis is described in the form of tables and narratives using SPSS version 20 for Windows.

Results: The results showed that there were 23 acute urticaria patients in this study, the age of the most research samples was in the Adult age category with a large percentage of 60.87%, the most gender-based study sample was female gender with a percentage of 78.3%, research genetic samples most of them are in the absence of genetics, with a percentage of 91.3%, the work of most research samples in housewives with a percentage of 34.8%, the most common cause of acute urticaria is in food allergies with a percentage of 56.5%.

Conclusion: The incidence of acute urticaria is most common in adulthood, female sex, housewives, and food allergies.

Skin flap pattern in skin cancer at Sanglah General Hospital Denpasar, Bali-Indonesia

Background: The prevalence of skin cancer is consistently increasing recently, an hence a more comprehensive management is necessary for patients’ satisfaction. Generally, skin cancer is categorized into several histological types, including melanoma, basalioma, squamous cell carcinoma (SCC), and several other less common types such as keratoacanthoma, pyogenic granuloma, and Bechet disease. In dermatology, the intervention is limited which only consists of infiltrative anesthesia, no involvement of other organs, and no attachment to the underlying tissue. Therefore, random skin flap frequently becomes the preferred option that involves advancement, rotation, transposition, and interpolation flap. This study aims to investigate the profile of skin cancer and flap pattern among patients undergoing skin flaps procedure at Dermatology and Venereology Department of Sanglah General Hospital, Denpasar. 

Method: This study included all skin cancer patients who underwent skin flap surgery. Samples collection was performed retrospectively using patients’ medical records from January 2015 - December 2018. 

Results: Over the study period, there were a total of 41 skin cancer patients who underwent skin flap surgery of whom 10 (54.6%) patients were diagnosed with melanoma, 16 patients with basalioma, 9 patients with SCC and the remaining included 3 cases of acanthoma and 1 Bechet disease. Regarding the flap types, simple advancement and its variances were performed in 6 melanoma, 11 basaliomas, 5 SCC and 4 keratoacanthoma cases. Transposition flap was performed in 2 melanoma, 3 basalioma, and 3 SCC cases; whereas rotation flap was performed in 2 melanoma and 2 basaliomas and SCC cases.

Conclusion: From 41 skin cancer patients discovered, basalioma was the most frequent cases and advancement techniques were the most frequently performed flap surgery. Only 1 post-surgical infection was found after rotational flap procedure.

Pengaruh ekspresi Vascular Endothelial Growth Factors (VEGF) post-neoadjuvant kemoterapi terhadap respon kemoterapi (huvos), local recurrence, metastasis, dan survival pada pasien osteosarkoma

Background: Overexpression of VEGF before therapy has been associated with decreased survival and poor prognosis of osteosarcoma patients, but VEGF expression in osteosarcoma patients following receiving neoadjuvant chemotherapy has not been much elucidated. The purpose of this study was to determine the effect of VEGF expression after neoadjuvant chemotherapy on chemotherapy responses (HUVOS), local recurrence, metastases and survival of osteosarcoma patients.

Methods: A cross-sectional study was conducted in Jakarta during the 2009-2010 period to 19 osteosarcoma patients at Cipto Mangunkusumo Hospital, Jakarta. Data on patient’s characteristics, VEGF expression after chemotherapy, local recurrence, metastasis, chemotherapy response and survival in osteosarcoma patients were recorded and analysed using statistical analysis. All data were analysed using SPSS software version 16 for Windows.

Results: Most respondents were male (63.2%), age> 14 years (84.2%), stage IIB (94.7%), poor HUVOS (73.7%), size <10 cm (63, 2%), positive VEGF expression (57.9%), negative metastasis (73.7%), and death (73.7%). There was no significant relationship between VEGF expression and all parameters assessed (P> 0.05).

Conclusion: VEGF expression by living osteosarcoma cells after neoadjuvant chemotherapy is not significantly related to histological response (HUVOS), local recurrence and metastasis, but has a significant relationship with good survival.

Nyeri meningkatkan resiko insomnia pada mahasiswa Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Udayana

Background: Pain and Insomnia are the main problems most commonly found in people at a young age, where the number of sufferers continues to increase as the population increases in young age. There are several things that can be done to find out whether pain increases insomnia, one of the way is to do the examination using a questionnaire. This study aims to determine the effect of pain increase the risk of sleep disorders in medical students at the Faculty of Medicine Udayana University.

Method: This study used case control design on 50 subjects divided into two groups equally, case group and control group. Then performed a risk analysis between pain, depression and anxiety against insomnia.

Results: This study proves the association of pain with insomnia, where (OR: 4,125; IK95%: 1,092-15,895; p = 0,031) and pain is a risk factor for insomnia. Significant values were also found in the association between insomnia and anxiety (OR: 5.091; IK95%: 1.446 - 17.922; p = 0.009), and anxiety was a risk factor for insomnia. Depression is not a risk factor for insomnia (OR: 2,263; 95% IK: 0.727 - 7.047; p = 0.156).

Conclusion: In this study pain, and insomnia is a risk factor of insomnia and depression are factors that are not associated with insomnia

The level of knowledge regarding breast cancer among female high school students at Santo Yoseph School, Denpasar, Bali, Indonesia

Background: Breast cancer is the second leading cause of death among women around the world. In Indonesia, breast cancer is the leading cause of death among women. Previous studies have shown that female students have limited knowledge of breast cancer. This study is aimed at assessing the level of breast cancer knowledge among female high school students in Santo Yoseph School, Denpasar.

Methods: A cross-sectional survey of 96 female high school students in Santo Yoseph School, Denpasar, was conducted using a self-administered questionnaire.  Questions asked in the questionnaire were about general knowledge of breast cancer, risk factors towards breast cancer, signs and symptoms of breast cancer and knowledge of Breast Self-Examination. The data was tabulated by scoring only the correct answers and analysed using SPSS version 17 for Windows.

Results: The result of the study showed that high school female students had moderate to good knowledge of breast cancer. Fifty-three (55.2%) female students had average knowledge and forty-three (44.8%) female students had good knowledge of breast cancer. The majority of the participants, seventy-five (78.1%) of them, knew that breast cancer was the leading cause of death among women in Indonesia.

Conclusion: The recent findings showed that female high school students had good knowledge of breast cancer. Good knowledge of breast cancer is important for girls and women equally.

Hubungan antara perilaku duduk pengrajin ukir kayu dengan nyeri punggung bawah di Kecamatan Tegallalang, Gianyar, Bali

Background: Low back pain is one of the health problems that are often encountered in workers. Some risk factors for low back pain are non-ergonomic sitting position, duration of work, working period, and rest breaks. Woodcarving craftsmen in Pupuan Village have a risk to experiencing low back pain complaint. The purpose of this study is determine whether sitting behaviors is related to low back pain.

Methods: An analytical observational study, designed in the form of a cross sectional study to determine the relationship between sitting behaviours with low back pain in Pupuan Village. Samples selected by a non-random consecutive sampling produced 69 samples and analysed using SPSS version 17.

Results: Most respondents complained of back pain (89.1%), especially in the lower back (85.5%), after work (95.2%), and improved with changes in sitting position (95.2%). The results of the bivariate analysis showed a significant relationship between age, sitting position, duration of work, length of work, and rest periods with complaints of low back pain (P <0.05).

Conclusion: There is a significant relationship between age, sitting position, duration of work, working period, and rest breaks with of low back pain complaint in wood carving craftsmen in Pupuan Village.

The characteristics of preeclampsia among patients delivered through caesarean section at Sanglah General Hospital, Denpasar, Bali in 2018

Background: Preeclampsia is an exclusive disorder in pregnancy characterised by hypertension as well as proteinuria and is the primary cause of mortality and morbidity of pregnant women. This study aims to determine the characteristics or risk factors in preeclampsia patients who delivered through caesarean section within the period of January 1^st to December 31^st 2018 in Sanglah General Hospital Denpasar.

Methods: This study used a retrospective descriptive study design by using 34 samples of preeclampsia patients in 2018 who underwent caesarean delivery in Sanglah General Hospital Denpasar. The characteristics of these pregnant women are categorized into their age, education level, Body Mass Index (BMI), ethnicity, occupation, education level, previous history of preeclampsia, family history of preeclampsia, existing chronic hypertension, parity, number of fetus in womb, frequency of Antenatal Care (ANC), and registration method. Data were analysed by SPSS version 17 for windows.

Results: The preeclampsia sufferers were dominated by the age group of 20-35 years as many as 27 people (79.4%). The highest body mass index is in the 1 obese group of 10 people (29.4%). The majority of respondents were from Bali (61.8%). Working women were predominant (67.6 %), followed by SMA education level (14.7%), existing chronic hypertension (5.9%), nulliparous (41.1%), single fetuses (94.1%), and total frequency of ANC to midwife/obstetrician consisting about 61.8%.

Conclusion: It can be concluded that the majority of the patients were in the age range of 20-35 years, were Balinese and had a BMI range of Obese I. Moreover, most the preeclampsia patients in this study were working women and had an education level mostly in SMA

The prevalence of panic disorder among English Class students at Medical Faculty, Universitas Udayana, Bali, Indonesia in 2018

Background: Panic disorder is diagnosed in people who experience spontaneous, seemingly out-of-the-blue panic attacks and are very preoccupied with the fear of a recurring attack. Panic disorder usually begins in adulthood (after age 20) and can interfere a lot with daily life, causing people to miss work, go to many doctor visits, and avoid situations where they fear they might experience a panic attack. This study aims to determine the prevalence of panic disorder among English Class students at Medical Faculty, Universitas Udayana, Bali, Indonesia in 2018

Methods: An observational cross-sectional study was conducted among 89 medical students from English Class at the Faculty of Medicine, Universitas Udayana in 2018 using total sampling techniques. A self-administered questionnaire was carried out to determine the prevalence of panic disorder by several valid and reliable questions. Data were analysed using SPSS version 20 for Windows and presented in frequency and percentage.

Results:  Most of the respondents were 20 years old (57.3%). There are only 12.0% of English class Semester 7 students are free from panic disorder, 51.0% suffers from mild panic disorder, and 37.0% suffers from moderate panic disorder. Around 64% of female respondents have panic disorder while 34% in male respondents. Female respondents are tended to get more panic attacks than male respondents in a ratio of 2:1.

Conclusion: Female medical students tend to have a higher risk of panic disorder compared with males. The majority age of students suffering from panic attacks is from 20 to 23 years old.

Pengaruh ekstrak krim Morinda citrifolia terhadap jumlah fibroblas pada penyembuhan luka tikus Wistar

Introduction. Wound healing is a complex biological process involving four stages, i.e., hemostasis, inflammation, proliferation, and remodeling. In the proliferation phase, there is an increase in the number of fibroblas cells. Morinda citrifolia is a fruit that contains the antioxidant compound, Quercetin. These antioxidant properties are thought to be able to accelerate the process of wound healing through the process of modulating the oxidative process and improving skin microstructure. The relationship of Quercetin to fibroblas cells which plays an essential role in the proliferation phase is not yet fully known. This study was conducted to determine the effect of Morinda citrifolia extracts on the number of fibroblas cells during the process of wound healing in Wistar rats.

Method. Experimental, post-test with control group study was conducted using 24 rats divided into four groups. In group I, rats were treated with incisions and given a Placebo cream, groups II, III and IV were given incisions and cream containing ethanol extract of Morinda citrifolia 5%, 10%, and 20% respectively. The number of fibroblass was calculated using the digital analysis method using Image Raster 3 Software. The number of fibroblas cells was calculated as the percentage of fibroblas cells seen in the field of view. Data analysis conducted with the One-Way ANOVA and Post-Hoc LSD test.

Results. The control group had an average number of fibroblas cells 23.3% ± 1.9%. The mean fibroblas cells in the intervention group with extracts of 5%, 10%, 20% were 27.6% ± 6.7%, 38.3% ± 8.8% and 22.3% ± 2.7%, respectively. The ANOVA test results showed a significant difference in the number of fibroblass between treatment groups (p<0.001). Post-hoc LSD test shown that only the treatment group with 10% extract showed a difference in the average number of fibroblas cells compared to the other groups.

Perbedaan kadar protein C, protein S, dan antitrombin III pada pasien dengan Sindrom Koroner Akut (SKA) di RSUP H. Adam Malik, Medan, Indonesia

Background: Acute coronary syndrome (ACS) is a life-threatening condition where coronary artery blockage results from thrombosis and leads to ischemia. Individuals with partial deficiency of protein C, protein S or antithrombin III have been found to play a role in increasing the risk of thrombosis. This study aims to determine differences in levels of protein C, protein S and antithrombin III in patients with ACS.

Methods: A cross-sectional study was carried out among 60 patients who were treated at H. Adam Malik General Hospital Medan and had fulfilled the inclusion and exclusion criteria through consecutive sampling techniques. Protein C, protein S and antithrombin III were examined with Coatron A4. Bivariate analysis was used to determine differences in the mean levels of protein C, protein S, and antithrombin III in ACS compared with healthy controls. Data were analyzed using SPSS version 17 for Windows.

Results: There were a significant difference in S protein levels between the STEMI, NSTEMI, and control groups (P <0.05). S protein levels in the STEMI group were significantly lower compared to NSTEMI and control (P <0.05). However, there were no significant differences in levels of protein C and AT-III between the STEMI, NSTEMI and control groups (P> 0.05).

Conclusion: There were no significant differences in ATIII and protein C levels between the STEMI, NSTEMI, and ATIII groups. However, in the S protein parameter, the S protein level was significantly different between STEMI, NSTEMI and the control group.

Profil gangguan fungsi kognitif pada pasien pasca stroke iskemik di RSUP Sanglah Denpasar Bali, Indonesia periode 2019

Background: Stroke is a disease that affects straightly to the brain. Stroke occured due to obstruction of blood vessel that contain blood-transporting  nutrients to the brain, which lead to impairment in brain function, as well as cognitive function. Because of  unavailibility of data in Sanglah General Hospital, this research must be done. This study aims to determine the cognitive function profile of post ischemic stroke patient in Sanglah General Hospital based on 5 cognitive domains.

Methods: This study is an observational study, collecting data by cross sectional. Data sources were obtained from primary data in the form of interview and MoCA-Ina Test with data retrieval methods using totally sampling technique. The accessible population was patients post ichemic stroke in Sanglah General Hospital that is in a good awareness and fit for MoCA-Ina test.

Results: From 26 patients that are accessible, 21 patients were diagnosed with cognitive impairment, which the majority in 41-50 range of age with 9 patients, male with 14 patients, last education of Junior High School with 7 patients, and memory being a domain which is most impaired with mean of 55,38% score.

Conclusion: The most affected domain is after an ischemic stroke is memory and visuospacial function

The effect of Euphorbia milii tea and its combination with Propolis on number of glomeruli in M.tb-infected mice: a histopathology study

Background: The role of both Euphorbia milii and Propolis is to increase the effectiveness in pathological condition of the body part damaged, include renal function in maintaining the homeostasis. That combination into mice which are infected by Mycobacterium tuberculosis will change the total number of glomerulus in the kidney.

Aim: The study aims to determine the effect of combination tea from Euphorbia milii and Propolis on the number of the glomerulus in mice infected by M. tb.

Method: This study confirmed randomized post-test only control group design consisting of 24 mice divided into six groups (G1-G6). E. milli flowers are obtained from flower plantations, in Ketewel, Gianyar, Bali Province took in fresh and dark red sampling. M. tuberculosis used H37Rv strain (ATCC27294) grown on Middlebrook 7H9 liquid medium for two weeks.

Result: It was found that Group 3 and Group 5 from the treatment group has the most significant average number of glomerulus which was 13, followed by Group 2 and Group 6 from the control group has the largest average number of glomerulus which was 12. The differences were not significant between groups with P = 0.463 (P <0.05).

Conclusion: The Euphorbia milii tea and its combination with Propolis does not affect histological change on the total number of glomerulus in mice infected with M. tb.

Gambaran faktor risiko dan tingkat risiko stroke iskemik berdasarkan stroke risk scorecard di RSUD Klungkung

Latar Belakang: Indonesia memiliki angka beban stroke terbanyak kedua setelah Mongolia yaitu sebanyak 3.382,2/100.000 orang berdasarkan DALYs (disability-adjusted life-year). Berdasarkan profil kesehatan provinsi Bali, tipe stroke yang memiliki tingkat prevalensi yang tinggi adalah stroke iskemik. Strategi praktis dalam mengatasi beban akibat stroke harus difokuskan pada pencegahan dan penanganan berdasarkan faktor risiko. Tujuan penelitian ini adalah untuk mengetahui hubungan antara faktor-faktor risiko dengan tingkat risiko penderita stroke iskemik yang rawat inap di RSUD Klungkung Bali periode Oktober 2017 sampai dengan September 2018.

Metode: Penelitian ini merupakan penelitian analitik observasional dengan desain cross sectional. 65 Subyek penelitian yang sesuai dengan kriteria inklusi, diambil dari data rekam medis pasien stroke iskemik yang rawat inap di RSUD Klungkung. Variabel yang diteliti dalam penelitian ini yaitu usia, jenis kelamin, tekanan darah, kadar kolesterol, riwayat merokok, indeks massa tubuh (IMT), aktivitas fisik, riwayat diabetes, riwayat fibrilasi atrium, dan riwayat stroke dalam keluarga.

Hasil: Dari total 65 pasien stroke iskemik yang rawat inap di RSUD Klungkung, paling banyak berada pada kelompok usia ≥ 55 tahun – 64 tahun dengan usia rerata 61,45 ± 12,016 tahun. Pasien berdasarkan jenis kelamin didominasi oleh laki-laki dengan perbandingan kejadian stroke iskemik antara laki-laki dan perempuan sebesar 2,4:1. Hasil penilaian tingkat faktor risiko dengan Stroke Risk Scorecard (SRS), 51 orang (78,5%) memiliki risiko tinggi, 9 orang (13,8%) memiliki risiko sedang, dan 5 orang (7,7%) memiliki risiko rendah.

Simpulan: Uji statistik chi-square menunjukkan adanya hubungan yang signifikan antara tingkat risiko stroke iskemik dengan indeks massa tubuh, tekanan darah, riwayat merokok, riwayat diabetes, dan kadar kolesterol (p<0,005).

Introduction: Indonesia is the second highest country of stroke burden after Mongolia, which are 3,382.2 / 100,000 people based on DALYs (disability-adjusted life-year). Based on the health profile of the province of Bali, the type of stroke that has high prevalence rate is ischemic stroke. Practical strategies in overcoming the burden of stroke must be focused on prevention and treatment based on risk factors. The study aims to determine the relationship between risk factors and the level of risk of ischemic stroke patients hospitalized at RSUD Klungkung Bali.

Methods: This study is observational analytic study with a cross sectional design that includes 65 patients taken from the medical records. The variables studied are age, gender, pressure blood, cholesterol levels, smoking history, body mass index (BMI), physical activity, history of diabetes, history of atrial fibrillation, and history of stroke in the family. Data analysis techniques used were univariate analysis and bivariate analysis.

Result: The most characteristics based on age group is ≥ 55 years - 64 years with an average age of 61.45 ± 12.016 years. Patients are dominated by men (2,4:1). The assessment of the level of risk factors in each sample using the Stroke Risk Scorecard (SRS), 51 people (78.5%) had a high risk, 9 people (13.8%) had moderate risk, and 5 people (7.7%) has a low risk of ischemic stroke.

Conclusion: The chi-square statistical analysis showed a significant relationship between the risk level of ischemic stroke with body mass index, blood pressure, smoking history, history of diabetes, and cholesterol levels (p<0,005).

Gambaran persepsi ibu terhadap obesitas pada anak usia sekolah dasar di Kecamatan Canggu, Kabupaten Badung, Bali tahun 2018

Latar Belakang: Obesitas adalah suatu keadaan terjadinya penumpukan lemak tubuh yang berlebih, sehingga berat badan seseorang jauh melebihi norma. Pemasalahan gizi lebih di Indonesia harus mendapatkan perhatian, prevalensi obesitas pada anak di indonesia terus meningkat. Pada tahun 2007 sebesar 7,95%, di tahun 2013 meningkat menjadi 18,8%.

Metode: Penelitian ini merupakan penelitian deskrtitif dengan rancangan penelitian cross sectional yang bertujuan untuk menggambarkan persepsi ibu terhadap obesitas pada anak usai sekolah dasar. Sempel dari penelitian ini adalah sebanyak 92 responden, dengan teknik pengambilan sempel random sampling dan penelitian ini menggunakan alat ukur kuesioner

Hasil: Ibu yang memiliki persepsi positif terhadap obesitas pada anak sebanyak 56,5% sedangkan ibu yang memiliki persepsi negatif terhadap obesitas pada anak sebanyak 43,5%

Simpulan: Masih banyak ibu yang menganggap bahwa obesitas pada anak bukan maslah bagi ksehatan anak.

Introduction: Obesity is a condition where there is excess body fat accumulation so that a person's weight is far above normal. The current problem of overnutrition in Indonesia must get attention; the prevalence of obesity in children in Indonesia continues to increase in 2007 by 7.95% and increased to 18.8% in 2013.

Method: This study is a descriptive study with a cross sectional study design that aims to describe mothers' perceptions of obesity in children after primary school. The samples from this study were 92 respondents, with random sampling technique and the research using a questionnaire measuring instrument.

Result: Mothers who have a positive perception of obesity in children as much as 56.5% while mothers who have a negative perception of obesity in children as much as 43.5%.

Conclusion: Based on these results it can be concluded that there are still many mothers who consider that obesity in children is not a problem for children's health.

Gambaran pemeriksaan IgM anti-Salmonella thypi 09 pada penderita demam dan gangguan pencernaan, dengan atau tanpa gangguan kesadaran di Puskesmas Denpasar Timur I

Latar Belakang: Demam tifoid merupakan penyakit endemik Indonesia, yang disebabkan oleh infeksi dari bakteri Salmonella typhi. Bakteri ini dapat ditularkan melalui makanan dan juga minuman yang terkontaminasi bakteri tersebut, bisa juga akibat dari terkontaminasi dari tinja maupun urin dari orang yang telah terinfeksi bakteri tersebut. Penegakan untuk diagnosis demam tifoid saat ini dapat dilakukan secara klinis maupun dengan cara pemeriksaan laboratorium. Salah satunya ialah uji serologis yang dapat digunakan dalam demam tifoid meliputi tes Tubex.

Metode: Penelitian ini merupakan penelitian deskriptif dengan pendekatan cross-sectional. Data dalam penelitian ini berasal dari sumber data primer berupa pengambilan serum pasien di Puskesmas Denpasar Timur I sejumlah 33 sampel.

Hasil: Pasien yang berobat ke Puskesmas Denpasar Timur I didapatkan kelompok yang paling banyak ialah perempuan 81,9% sedangkan laki-laki 18,1%. Sebanyak 100% datang dengan keluhan demam, sebanyak 63,7% datang dengan keluhan mual dan muntah 9,0%.

Simpulan: Hasil IgM anti-Salmonella thypi 09 positif sebanyak 9,1% dan IgM anti-Salmonella thypi 09 negatif sebanyak 90,9%.

Introduction: Typhoid fever is an endemic disease in Indonesia, which is caused by an infection of the bacterium Salmonella typhi. These bacteria can be transmitted through food and beverages contaminated with these bacteria, can also be caused by contamination of feces and urine from people who have been infected with these bacteria. Enforcement for the diagnosis of typhoid fever can now be done clinically or by laboratory examination. One of them is the serological test that can be used in typhoid fever including the Tubex test.

Method: This research is a descriptive study with a cross-sectional approach. The data in this study came from primary data sources in the form of taking serum of patients in the East Denpasar Health Center I with 33 samples.

Result: Patients who went to the East Denpasar Public Health Center I, found the most group was women 81.9% while men 18.1%. As many as 100% came with complaints of fever, 63.7% came with complaints of nausea and vomiting were 9.0%.

Conclusion: The positive results of anti-Salmonella thypi 09 were 9.1% and negative IgM anti-Salmonella thypi 09 as much as 90.9%.

Hubungan antara obesitas sentral dengan kadar Hba1c pada penduduk usia 30-50 tahun di Lingkungan Batursari Desa Bitera, Gianyar

Introduction: Central obesity is condition there is an accumulation of intraabdominal and subcutaneous fat that occurs in the abdominal area which can cause insulin resistance so that glucose is difficult to enter the cell and causes blood glucose levels to increase in Type 2 Diabetes Mellitus. Waist circumference is one indicator used for measure central obesity. This study aims to determine the relationship between central obesity and HbA1c levels.

Methods: This study was observational analytic with a cross sectional approach. The study population was adults aged 30-50 years in the Batursari, Bitera Village, Gianyar. Data taken included age, sex, occupation, waist circumference, BMI, HbA1c levels in 50 respondents taken by purposive sampling method. The relationship between central obesity and HbA1c levels was analyzed using Pearson correlation test with a significance level of 0.05.

Result: The majority of the sample were central obesity based on waist circumference (60%). The number of respondents with HbA1c level ≥ 6.5% by 30%. Pearson Product Moment correlation test between central obesity and HbA1c level with p = 0.001 and Pearson Correlation r = 0.456.

Conclusion: There is a significant positive relationship between central obesity and HbA1c levels

Latar Belakang: Obesitas sentral adalah suatu keadaan dimana adanya akumulasi lemak intraabdominal dan subkutan yang terjadi di daerah abdomen yang dapat menyebabkan resistensi insulin sehingga glukosa sulit untuk memasuki sel dan menyebabkan kadar glukosa darah meningkat pada penyakit Diabetes Mellitus Tipe 2. Lingkar pinggang merupakan salah satu indikator yang digunakan untuk mengukur obesitas sentral. Penelitian ini bertujuan untuk mengetahui tentang hubungan antara obesitas sentral dengan kadar HbA1c.

Metode: Penelitian ini bersifat observasional analitik dengan pendekatan cross sectional. Populasi penelitian adalah penduduk dewasa usia 30-50 tahun di Lingkungan Batursari, Desa Bitera, Gianyar. Data yang diambil meliputi usia, jenis kelamin, pekerjaan, lingkar pinggang, IMT, kadar HbA1c pada 50 responden yang diambil dengan metode purposive sampling. Hubungan antara obesitas sentral dengan kadar HbA1c dianalisis dengan menggunakan uji korelasi Pearson dengan derajat kemaknaan 0,05.

Hasil: Hasil penelitian menunjukkan bahwa sebagian besar mengalami obesitas sentral berdasarkan lingkar pinggang (60%). Jumlah responden dengan kadar HbA1c ≥ 6,5% sebesar 30%. Uji korelasi Pearson Product Moment antara obesitas sentral dengan kadar HbA1c dengan nilai p = 0,001 dan nilai Pearson Correlation r = 0,456.

Simpulan: Terdapat hubungan positif bermakna antara obesitas sentral dengan kadar HbA1c.

Pemeriksaan widal untuk mendiagnosis Salmonella typhi di Puskesmas Denpasar Timur 1

Introduction: Typhoid fever is an acute systemic infectious disease caused by Salmonella typhi which is still widely found in various developing countries, especially in the tropics and subtropics. Widal test is an agglutination reaction between antigen and S. typhi O titer antibodies> 1/160 and S. typhi H titer >1/160, Aglutinin that is specific to Salmonella typhi in the serum of patients with typhoid fever.

Methods: This research was descriptive observational cross sectional. The population of the study was patients from the East Denpasar Health Center 1 who presented with clinical symptoms that supported.

Result: There were 10 sample (30%) aged 0-10 years, 12 sample (36%) people aged 11-20 years, 7 sample (21%) aged 21-30 years, and 4 sample (12%) people aged >30 year. Samples with clinical symptoms of fever> 37 ° C with digestive disorders (nausea, vomiting, abdominal pain) with or without impaired consciousness were 18 samples (55%). Samples with clinical symptoms of fever> 37 ° C with digestive tract disorders were 11 samples (33%). Samples with fever> 37 ° C were 4 samples (12%)

Conclusion: There were 3% of positive widal test and 97% of negative widal test in the East Denpasar Health Center 1.

Latar Belakang: Demam tifoid merupakan suatu penyakit infeksi akut sistemik yang disebabkan oleh Salmonella typhi yang masih dijumpai secara luas di berbagai negara berkembang terutama di daerah tropis dan subtropics. Uji Widal adalah suatu reaksi aglutinasi antara antigen dan antibody S. typhi O titer > 1/160 dan S. typhi H titer >1/160, Aglutinin yang spesifik  terhadap  Salmonella  typhi  terhadap dalam serum penderita demam  tifoid.

Metode: Penelitian ini bersifat observasional cross sectional deskriptif Populasi Penelitian adalah pasien dari Puskesmas Denpasar Timur 1 datang dengan gejala klinis yang mendukung.

Hasil: Rentang usia dari 33 pasien subjek penelitian, terdapat 10 sampel(30%) berusia 0 – 10 tahun, 12 sampel  (36 %) sampel berusia 11 – 20 tahun, 7 sampel (21%) berusia 21-30 tahun,  dan 4 sampel  (12 %) sampel berusia > 30 tahun. Sampel dengan gejala klinis demam > 37 °C dengan gangguan pencernaan (mual, muntah, nyeri perut) dengan atau tanpa gangguan kesadaran sebanyak 18 sampel (55%). Sampel dengan gejala klinis demam > 37°C dengan gangguan saluran pencernaan sebanyak 11 sampel (33%). Sampel dengan demam >37°C sebanyak 4 sampel (12%)

Simpulan: Terdapat 3% sampel dengan widal positif dan 97% sampel dengan widal negatif di Puskesmas Denpasar Timur 1.

Gambaran biaya rawat inap pengobatan pneumonia pada pasien anak di RSUP Sanglah tahun 2018

Introduction: Pneumonia is the leading cause of death on children in Indonesia with a percentage reaching 21%, especially in infants aged less than 2 months. In the world, this disease is the number one killer of children where more than two million children have died from it, or causes one in five under-five deaths worldwide every year. High pneumonia morbidity and mortality rates are closely related to the quality of services, and the quality of resources in a health facility, up to the cost of treatment.

Method: This research is an observational research with descriptive research design, and uses crossectional data collection methods (cross section). This study aims to determine the description of pneumonia treatment consisting of direct medical costs, direct non-medical costs, and indirect costs of the average cost therapy for pneumonia in pediatric patients at the Sanglah Hospital inpatient care in 2018.

Result: Data were obtained from 21 samples of children with pneumonia. The average direct medical cost of patients was Rp. 3,838,270, the average direct non-medical cost is Rp. 1,443,076, and the average indirect cost is Rp. 941.905.

Conclusion: The average direct medical cost of a patient is Rp. 3,838,270, room costs are the largest component, 26.9% of the average total medical costs. The average direct non-medical cost of patients is Rp. 1,443,076, consumption costs are the largest component of non-medical costs, 51.3% of the average total non-medical costs. Average patient indirect costs are Rp. 941.905, maternal productivity costs are the largest indirect cost component, 67.8% of the average total indirect costs.

Latar Belakang: Pneumonia merupakan penyebab utama kematian pada balita di Indonesia dengan persentase mencapai 21%, terutama pada bayi yang berumur kurang dari 2 bulan. Di dunia, penyakit ini menjadi pembunuh nomor satu balita dimana lebih dari dua juta balita telah meninggal karenanya, atau penyebab satu dari lima kematian balita di seluruh dunia setiap tahunnya. Angka kesakitan dan kematian pneumonia yang tinggi sangat terkait dengan mutu layanan dan kualitas sumber daya di suatu fasilitas kesehatan, sampai dengan pembiayaan terapinya.

Metode: Penelitian ini merupakan jenis penelitian observasional dengan rancangan penelitian deskriptif, dan menggunakan metode pengambilan data crossectional (potong lintang) untuk mengetahui gambaran pengobatan pneumonia yang terdiri dari biaya medis langsung, biaya non medis langsung, dan biaya tidak langsung dari rata-rata biaya terapi pneumonia pada pasien anak di instalasi rawat inap RSUP Sanglah pada tahun 2018.

Hasil: Data dari 21 sampel pasien pneumonia anak, rerata biaya medis langsung pasien adalah sejumlah Rp. 3.838.270, rerata biaya non medis langsung adalah sejumlah Rp. 1.443.076, dan reratabiaya tidak langsung adalah sejumlah Rp. 941.905.

Simpulan: Rerata biaya medis langsung pasien adalah sejumlah Rp. 3.838.270, biaya kamar adalah komponen terbesar, 26.9% dari rerata total biaya medis. Rerata biaya non medis langsung pasien adalah Rp. 1.443.076, biaya konsumsi adalah komponen biaya non medis terbesar, 51.3% dari rerata total biaya non medis. Rerata biaya tidak langsung pasien adalah Rp. 941.905, biaya produktifitas ibu adalah komponen biaya tidak langsung terbesar, 67.8% dari rerata total biaya tidak langsung.

Hubungan kadar gula darah dengan hipertensi pada pasien diabetes mellitus tipe 2 di RSUP Sanglah

Background: Diabetes mellitus is a metabolic disease with a large number of cases and is characterized by conditions of hyperglycemia that occur due to abnormal insulin secretion, insulin action or both. One of the complications of diabetes is a stroke caused by hypertension. Therefore, this study aims to determine the relationship of blood sugar levels with hypertension in patients with type 2 diabetes mellitus at Sanglah General Hospital.

Methods: This study used observational analytic research with a cross-sectional approach. The subjects in this study were patients with type 2 diabetes mellitus who entered the inclusion and exclusion criteria. The instrument used was a mercury meter to measure blood pressure, as well as medical record data to see blood glucose levels. Data obtained were analyzed using SPSS v. 22 to carry out the Pearson correlation test with a significance value of p <0.05.

Results: 45 respondents enrolled in this study, with an average age of 64.38 ± 9.719 years. Age 60 - 80 years (55.6%) and women (51.1%) were dominant in this study. Obtained respondents with conditions of hyperglycemia as much as 17.8% and experiencing stage 1 hypertension of 66.7% and stage 2 hypertension of 33.3%. The results of hypothesis testing with Pearson correlation test obtained r= -0.532 and p = 0.041 on systolic blood pressure and r = -0.535 and p = 0.040 on diastolic blood pressure (p <0.05).

Conclusions: There is a correlation between blood glucose levels with hypertension in patients with type 2 diabetes mellitus.

Latar Belakang: Diabetes mellitus merupakan suatu penyakit metabolik dengan jumlah kasus yang besar serta ditandai dengan kondisi hiperglikemia yang terjadi karena kelainan sekresi insulin, kerja insulin atau kedua-duanya. Salah satu komplikasi dari diabetes adalah stroke yang disebabkan oleh hipertensi. Penelitian ini bertujuan untuk mengetahui hubungan kadar gula darah dengan hipertensi pada penderita diabetes mellitus tipe 2 di RSUP Sanglah.

Metode: Penelitian ini menggunakan penelitian observasional analitik dengan pendekatan secara cross-sectional. Subjek dalam penelitian ini adalah pasien diabates mellitus tipe 2 yang masuk kriteria inklusi dan eksklusi. Instrumen yang digunakan adalah tensi meter air raksa untuk mengukur tekanan darah, serta data rekam medik untuk melihat kadar glukosa darah. Data yang diperoleh di analisis menggunakan SPSS v. 22 untuk dilakukan uji korelasi pearson dengan nilai signifikansi p < 0,05.

Hasil: 45 responden ikut serta dalam penelitian ini, dengan rerata usia 64,38 ± 9,719 tahun. Usia 60 – 80 tahun (55,6%) dan perempuan (51,1%) dominan dalam penelitian ini. Diperoleh responden dengan kondisi hiperglikemia sebanyak 17,8% dan mengalami hipertensi tahap 1 sebesar 66,7% serta hipertensi tahap 2 sebesar 33,3%. Hasil uji hipotesis dengan uji korelasi pearson diperoleh r= -0,532 dan p= 0,041 pada tekanan darah sistolik dan r= -0,535 dan p= 0,040 pada tekanan darah diastolik (p< 0,05).

Simpulan: Terdapat hubungan antara kadar gula darah dengan hipertensi pada penderita diabetes mellitus tipe 2.

Pengaruh ekstrak kulit buah naga merah (Hylocereus polyrhizus) terhadap kadar malondialdehyde (MDA) Paru pada tikus yang diberi paparan asap rokok

Background: Peel of a red dragon fruit (Hylocereus Polyrhizus) is rarely utilized which is usually just thrown way, even though it contains such high antioxidants such as phenols, flavonoids and also anthocyanins.

Methods: This study aims to determine the effect of red dragon fruit skin extract (Hylocereus Polyrhizus) on MDA levels of lung in rats exposed to cigarette smoke. This research is an experimental study with Post-Test Only Control Group Design. The sample consisted of 30 rats aged 2-3 months which were divided into 5 groups each amounting to 6 rats, namely 1 negative control group was not given exposure to cigarette smoke, 1 group of positive cock was exposed to cigarette smoke, 3 treatment groups were given exposure cigarette smoke and administration of red dragon fruit skin extract with doses of 20mg, 40mh and 80mg for 14 days. The parameters measured were MDA levels of the lung.

Results: The mean MDA level of lung control group 1 was 0.146 ± 0.02 nmol / ml, the mean of control group 2 was 0.166 ± 0.01 nmol / ml, the mean of treatment group 1 was 0.168 ± 0.03 nmol / ml, treatment group 2 was 0.153 ± 0.02 nmol / ml, and treatment group 3 was 0.776 ± 0.09 nmol / ml. The significance analysis with the One Way Anova test shows that the value of F = 1.34 and the value of p = 0.282, where the value of p> 0.05

Conclusion: There was no significant difference between the control group and the treatment group or between treatment group 1, treatment 2 and treatment 3. 

Latar Belakang: Kulit buah naga merah (Hylocereus Polyrhizus) merupakan limbah yang sangat jarang dimanfaatkan, biasanya kulit buah naga merah hanya dibuang begitu saja, padalah mengandung antioksidan yang begitu tinggi seperti fenol, flavonoid dan juga antiosianin.

Metode: Penelitian ini bertujuan untuk mengetahui pengaruh ekstrak kulit buah naga merah (Hylocereus Polyrhizus) terhadap kadar MDA paru pada tikus yang dipaparkan asap rokok. Penelitian ini merupakan penelitian eksperimental dengan Post-Test Only Control Group Design. Sampel terdiri dari 30 ekor tikus yang berumur 2-3 bulan yang dibagi menjadi 5 kelompok masing-masing berjumlah 6 ekor tikus, yaitu 1 kelompok kontrol negative tidak diberikan paparan asap rokok, 1 kelompok kontrol positif diberikan paparan asap rokok, 3 kelompok perlakuan diberikan paparan asap rokok dan pemberian ekstrak kulit buah naga merah dengan dosis 20mg, 40mg dan 80mg selama 14 hari. Parameter yang diukur adalah kadar MDA paru.

Hasil: Rerata kadar MDA paru kelompok kontrol 1 adalah 0,146 ± 0,02 nmol/ml, rerata kelompok kontrol 2 adalah 0,166 ± 0,01 nmol/ml, rerata kelompok perlakuan 1 adalah 0,168 ± 0,03 nmol/ml, kelompok perlakuan 2 adalah 0,153 ± 0,02 nmol/ml, dan kelompok perlakuan 3 adalah 0,776 ± 0,09 nmol/ml. Analisis kemaknaan dengan uji One Way Anova menunjukan bahwa nilai F= 1,34 dan nilai p= 0,282, dimana nilai p>0,05

Implementasi lintas diare dan penggunaan obat antidiare pada anak dengan diare

Introduction: Diarrhea is still a major problem that causes illness and death for children in Indonesia. Inappropriate care, both at home and in health agencies, is a major cause of deaths of children with diarrhea.

Method: The design of this study was descriptive with a cross sectional study design. The design of this study aims to be able to describe the implementation of cross diarrhea and the use of antidiarrheal drugs for pediatric patients with diarrhea at RSUP Sanglah Denpasar. The data used in the form of secondary data obtained from the medical records of Sanglah Hospital RSUP patients Denpasar January 2017-April 2017. The technique of determining the sample used is total sampling where all target populations that meet the criteria are included as samples.

Result: The most widely used cross group of diarrheas was ORS (Oral Rehydration solution) (17.9%). The most commonly used antidiarrhea drug is adsorbent (11.6%).

Conclusion: The most widely used cross-diarrhea group was ORS (Oral Rehydration solution) followed by the antibiotic group and so on the zinc group. There are minority cases that have given negative results on antibiotics. The most widely used group of antidiarrheal drugs was the adsorbent followed by the class of antimotility drugs and so on other classes of drugs such as probiotics and herbal medicines

Latar Belakang: Diare masih menjadi masalah utama yang menyebabkan sakit dan kematian bagi anak-anak di Indonesia. Perawatan yang tidak tepat, baik dirumah maupun di instansi kesehatan, merupakan penyebab utama kematian anak-anak dengan diare.

Metode: Rancangan penelitian ini bersifat deskriptif dengan rancangan penelitian cross sectional. Rancangan penelitian ini bertujuan untuk dapat menggambarkan implementasi lintas diare dan penggunaan obat antidiare terhadap pasien anak dengan diare di RSUP Sanglah Denpasar. Data yang digunakan berupa data sekunder yang didapat dari rekam medis pasien Anak RSUP Sanglah Denpasar bulan Januari 2017-April 2017. Teknik penentuan sampel yang digunakan adalah total sampling dimana seluruh populasi target yang memenuhi kriteria dimasukan sebagai sampel.

Hasil: Golongan lintas diare paling banyak digunakan adalah cairan rehidrasi yaitu oralit sebanyak 34 (17,9%). Penggunaan obat antidiare paling sering digunakan adalah adsorben sebanyak 22 (11,6%).

Insiden kegemukan pada masyarakat vegetarian di asrama Sri Sri Radha Vrndavan Candra Singaraja

Background: Obesity is one of the health and nutrition problems of the world community, both in developed countries and in developing countries. One effort to solve obesity is being a vegetarian. Vegetarian diet is a diet that only requires vegetable products with or without milk and eggs. This study aims to study the event of obesity in the vegetarian community in the dormitory of Sri Sri Radravanavan Chandra Singaraja.

Methods: This type of descriptive research is carried out by using a retrospective approach. Data collection starting from events that have occurred or are ongoing to do a description of general characteristics and specific variables of the study to answer the research objectives. Variables that have been recorded will be determined by the prevalence of hypertension and overweight. The subjects of the study were hypertensive patients in middle-aged with overweight based on data obtained from East Denpasar Puskesmas I. Sampling was done using a random sampling method. the type of research is descriptive study, that means this research only makes a description of the data that has been obtained by using a questionnaire on vegetarians in the dormitory of Radha Vrindavan Candra Singaraja. Data retrieval was taken by the Total Sampling method. Distribution of researcsh variables were BMI, Percent fat and Hip Waist Circumference. 30 samples that meet the inclusion criteria were included in this study.

Results: body mass index variables show that in Male as many as 12 samples (80%) were classified as healthy and had an average body mass index (SB) of 22.9 (2.13) kg / m2. In the variable body mass index, 14 of female samples (93.3%) were classified as healthy and had a mean body mass index (SB) of 23.7 (1.63) kg / m2. In Percent Body Fat variables, male shows as many as 4 samples (26.7%) are included in the category of slightly overlap with an average Percent Body Fat (SB) of 15.6 (4.96%). In Percent Body Fat variables, females as many as 11 samples (73.3%) were optimal, with an average Percent Body Fat (SB) of 17.4 (3.24%). In the Hip Waist Ratio variable male as many as 9 samples (60%) were at risk of replacing obesity, with an average Hip Waist Ratio (SB) of 0.9 (0.03%). In the female Hip Waist Ratio variable, 12 samples (80%) were at risk of obtaining mercy with an average Hip Waist Ratio (SB) of 0.87 (0.02%).

Conclusions: Based on body mass index, in the male sample it was found that 20% were overweight, while women were only 6.7%. Based on Percent Body Fat, the incidence of obesity was only found in male sex (20%), 13.3% of women included in the slightly overfat category. Based on the Hip Waist Ratio, 80% of women are at risk of obesity, while men are 60%.

Latar Belakang: Kegemukan merupakan salah satu masalah kesehatan dan gizi masyarakat dunia, baik di negara maju maupun di negara berkembang. Salah satu upaya mengatasi kegemukan adalah dengan mengatur pola makan vegetarian Vegetarian adalah pola makan yang hanya mengkonsumsi produk nabati dengan atau tanpa susu dan telur. Penelitian ini bertujuan untuk mengetahui kejadian kegemukan pada masyarakat vegetarian di asrama sri sri radha vrndavan candra singaraja.

Metode: Jenis penelitian ini deskriptif yaitu rancangan penelitian yang hanya melakukan deskripsi mengenai data yang telah diperoleh yaitu dengan menggunakan kuisioner pada masyarakar vegetarian di asrama ari ari radha vrndavan candra singaraja. Pengambilan data di ambil dengan metode Total Sampling. Distribusi variable penelitian yaitu IMT, Persen lemak dan Lingkar Pinggang Pinggul. 30 sampel yang termasuk kriteria inklusi diikutsertakan dalam dalam penelitian ini.

Hasil: laki-laki sebanyak 12 sample (80%) tergolong healty dan memiliki rata-rata Indeks Masa Tubuh (IMT) (SB) 22,9 (2,13) kg/m². IMT perempuan 14 sample (93,3%) tergolong healty dan memiliki rata-rata IMT (SB) 23,7 (1,63) kg/m². PLT laki-laki sebanyak 4 sampel (26,7%) termasuk dalam kategori slighty overfat dengan rata-rata PLT (SB) 15,6 (4,96%). Persen Lemak Tubuh (PLT) perempuan sebanyak 11 sampel (73,3%) tergolong optimal, dengan rata-rata PLT (SB) 17,4 (3,24%). RLPP laki-laki sebanyak 9 sampel (60%) beresiko mengalami kegemukan, dengan rata-rata Rasio Lingkar Pinggang Pinggul (RLPP) (SB) 0,9 (0,03%). RLPP perempuan yaitu 12 sampel (80%) beresiko mengalami kegemukan dengan rata-rata RLPP (SB) 0,87 (0,02%).

Hubungan posisi dan lama duduk dengan nyeri punggung bawah pada pemain game online

Introduction: The public's interest in online games is seen by the growing number of internet cafes and online games that are increasingly in Indonesia. Online games are starting to be considered something addictive. Position and duration of playing online game players that are usually more than 4 hours causes online game players often experience lower back pain. This study aims to determine the position and duration of sitting with low back pain in online game players.

Methods: This study is a cross-sectional analytic study with a qualitative study design. The research data uses primary data taken directly by filling out the questionnaire in Game Online in the West Denpasar sub-district for the period November 2018 to December 2018. The sample collection technique uses the total sampling method.

Result: The total sample in this study was 80 respondents, based on age distribution ranging from 17 to 30 years with an average age of 20.86 years. The highest proportion of body mass index in the risk group (> 23.0) was 55 people (68.75%). The proportion of ergonomic sitting positions is 20 people (25%) while the proportion of non-ergonomic sitting positions is 60 people (75%). The proportion of respondents who sat ≤4 hours was 23 people (28.75%) while the proportion of respondents sitting> 4 hours was 57 people (71.25%). The proportion of respondents who complained of low back pain was 60 people (75%) and those who did not complain of 20 lower back pain (25%). The highest proportion who experience low back pain in respondents with non-ergonomic sitting position is 75%. The highest proportion who experienced low back pain in respondents with a sitting time> 4 hour was 71.25%.

Conclusion: Non-ergonomic sitting position and duration sitting that more than 4 hours are risk factors that affect lower back pain in online game players.

Latar Belakang: Ketertarikan masyarakat terhadap game online tampak dengan berkembangnya usaha warung internet dan game-online yang semakin banyak di Indonesia. Aktivitas duduk dengan posisi dan durasi waktu bermain pemain game online yang biasanya lebih dari 4 jam menyebabkan para pemain game online sering mengalami nyeri punggung bawah. Penelitian ini bertujuan untuk mengetahui hubungan posisi dan lama duduk dengan nyeri punggung bawah pada pemain game online.

Metode: Penelitian ini merupakan penelitian analitik cross-sectional dengan desain studi kualitatif. Data penelitian menggunakan data primer yang diambil langsung dengan pengisian kuisioner di Game Online wilayah kecamatan Denpasar Barat periode November 2018 hingga Desember 2018. Teknik pengumpulan sampel menggunakan metode total sampling.

Hasil: Total sampel pada penelitian ini adalah 80 responden, berdasarkan distribusi usia berkisar 17 hingga 30 tahun dengan rerata usia 20,86 tahun. Proporsi indeks massa tubuh terbanyak pada kelompok berisiko (>23,0) sebanyak 55 orang (68,75%). Proporsi posisi duduk ergonomis sebanyak 20 orang (25%) sedangkan proporsi posisi duduk tidak ergonomis sebesar 60 orang (75%). Proporsi responden yang duduk 4jam sebesar 23 orang (28,75%) sedangkan proporsi responden yang duduk >4jam sebesar 57 orang (71,25%). Proporsi responden yang mengeluh nyeri punggung bawah ada 60 orang (75%) dan yang tidak mengeluh adanya nyeri punggung bawah sebanyak 20 orang (25%). Proporsi paling banyak yang mengalami nyeri punggung bawah pada responden dengan posisi duduk tidak ergonomis sebesar 75%. Proporsi paling banyak yang mengalami nyeri punggung bawah pada responden dengan lama duduk >4jam sebesar 71,25%.

Pengaruh kebiasaan merokok terhadap kejadian disfungsi ereksi pada petugas keamanan di Universitas Udayana Sudirman

Introduction: Smoking habits are behaviors that are now still seen in various country and these behaviors are really difficult to eliminate. Each cigarette dangerous chemicals like nicotine that can be effect to health especially smokers, one of this effect is erectile dysfunction. In this Study, the aim was to determine how much influence smoking habits can affect to erectile problem in security officers at Udayana University Sudirman.

Methods: This is a cross-sectional descriptive study that was conducted at Udayana Universitas Sudirman with 10 participants and obtained from filling IIEF-5 questionnaire (International Index of Erectile Dysfunction) and active smoker questionnaire that were distributed directly to the participants.

Result: The results of this study was shown that almost 40% security officers had mild erectile dysfunction. This study is observer from Non-Probability Sampling especially in convenient sampling to look the effect of smoking habits that against erectile dysfunction.

Conclusion: The security officer at Udayana University in Sudirman with smoking habits almost all experienced erectile dysfunction with different categories of erectile dysfunction.

Latar Belakang: Kebiasaan merokok merupakan perilaku yang sekarang masih terlihat di berbagai negara dan perilaku tersebut sulit untuk menghilangkannya. Pada setiap batang rokok terkandung zat kimia yang berbahaya kesehatan para perokok dan salah satunya adalah Disfungsi Ereksi. Penelitian ini bertujuan untuk mengetahui seberapa besar pengaruh kebiasaan merokok terhadap kejadian DE pada petugas keamanan di Universitas Udayana Sudirman.

Metode: Jenis penelitian ini adalah Cross-sectional Descriptive Study. Penelitian ini dilakukan di Kampus Universitas Udayana Sudirman dengan jumlah responden 10 orang dan didapatkan dari pengisian kuesioner IIEF-5 (International Inde of Erectile Function) dan kuesioner perokok aktif yang dibagikan secara langsung pada responden.

Hasil: Dari hasil penelitian ini, menunjukan bahwa dari 10 petugas keamanan didapatkan 40% mengalami DE ringan. Di uji dari Non-Probability Sampling khususnya Convenient Sampling terhadap pengaruh kebiasaan merokok pada disfungsi ereksi.

Profil hasil pemeriksaan CT-Scan pada pasien tumor paru di Bagian Radiologi RSUD Dr. Zainoel Abidin periode Juli 2018-Oktober 2018

Latar Belakang: Tumor paru masih menjadi penyebab utama keganasan di dunia. Tumor paru merupakan pertumbuhan abnormal benjolan pada jaringan paru yang dapat bersifat jinak ataupun ganas. CT scan merupakan salah satu modalitas yang digunakan untuk mengevaluasi dan mendiagnosis kecurigaan tumor paru. Penelitian ini bertujuan untuk mendapatkan gambaran profil hasil pemeriksaan CT scan pasien tumor paru.

Metode: Jenis penelitian yang digunakan adalah studi deskriptif retrospektif. Pengambilan sampel dilakukan di Bagian Radiologi RSUD Dr. Zainoel Abidin periode Juli 2018 – Oktober 2018. Data diperoleh dari hasil ekspertisi CT scan toraks dan kuisioner karakteristik responden. Didapatkan 66 kasus tumor paru yang memenuhi kriteria inklusi.

Hasil: Berdasarkan diagnosis radiologis, ditemukan 66 kasus tumor paru, dimana sebagian besar pasien berjenis kelamin laki-laki (63,6%); dengan kelompok usia terbanyak pada usia 60-69 tahun (37,9%); merokok aktif meningkatkan faktor risiko pada tumor paru; pasien memiliki gejala klinis awal terbanyak nyeri dada dan sudah dalam stadium lanjut; lokasi tumor terbanyak adalah paru kanan; dan tulang merupakan lokasi metastasis terbanyak ditemukan pada kasus tumor paru penelitian ini.

Simpulan: Penelitian ini diharapkan dapat memberikan umpan balik positif bagi manajemen tumor paru dan dapat digunakan sebagai dasar acuan untuk penelitian selanjutnya.

Background: Lung tumor is still being the most common tumors in the world. Lung tumor is defined as the abnormal growth of lumps in lung tissue that might be benign or malignant. CT scan is one of the most appropriate modality to diagnose the supposition of lung tumors and evaluating the tumor itself. The purpose of this study is to identify the CT scan images of patients with a lung tumor.

Method: The study was conducted by a retrospective descriptive design. In this study, sampling was performed at Radiology Department, Zinoel Abidin General Hospital, from July 2018 to October 2018. Data were obtained from the thorax CT scan examination request forms and questionnaire of respondent characteristics. There were 66 cases of lung tumors that met the

 inclusion criteria.

Results: There were 66 cases (53.2%) of lung tumors based on the radiological diagnosis. Most of the cases were males (63.6%); the largest age group consisted of patients aged 60-69 (37.9%); active smoking was the most important risk factor of lung tumor; patients mostly came with chest pain as an early symptom and at the final stage of lung tumor; the most common site of lung tumor was right lung; bone was the most common site of metastatic site.

Conclusion: This study can provide positive feedbacks in the whole management of lung tumor, and can be used as a basis for further research.

Utilisation of interactive media as health promotion in preventing and controlling blood sugar levels among type 2 diabetes mellitus patients: a systematic review

Background: The use of interactive media as a health promotion media has continued to develop in the past few decades. This technology is used to manage various acute and chronic diseases, one of which is diabetes mellitus. This systematic review aims to describe an intervention that utilises technology as a tool in the form of interactive media in conducting preventative health promotion and glucose control for type 2 diabetes.

Methods: The databases used include ProQuest, PubMed, Science Direct and Google Scholar. The keywords used in article search are research, interactive media, type 2 diabetes, health promotion, telemedicine, web-based, obesity, diabetes exercise, walking, glucose control. Inclusion criteria are 1) articles published in 2014-2018 in English, 2) articles which the main content is about using interactive media for diabetes type 2 problems. Exclusion criteria are 1) literature that is not relevant to the purpose of writing, 2) researching the interactive media but not applied to the problem of type 2 diabetes, 3) duplication, and 4) published articles incomplete. Thus, there were 1442 articles and only 12 articles that were used in accordance with the inclusion and exclusion criteria.

Results: This systematic review found that the effective results in the implementation of preventive health promotion and glucose control of type 2 diabetes by utilising technology particularly interactive media.

Conclusion: The 12 articles used in this study revealed that the implementation of preventive health promotion by utilising technology particularly interactive media was sufficient to control the glucose levels of among patients with type 2 Diabetes Mellitus.

Remaja pria 18 tahun dengan hipogonadotropik-hipogonadisme dan postur tubuh pendek: sebuah laporan kasus

Background: Hypogonadotropic hypogonadism (HH) is congenital or acquired disease affects hypothalamus or pituitary, so the secretion of GnRH, FSH, LH, and testosterone are inadequate. Clinical manifestations both physical and psychological impair patient’s quality of life, so authors try to report this case.

Case description: An 18 years old man complained about a small penis. Small penis cause patient had introvert personality and problems in social relations. On anthropometric status, body weight was below 3^rd percentile, height was below 3^rd percentile, and body mass index (BMI) was thin. The genital examination was 2^nd-grade tanner, penis with 3 cm length and 3 cm circumference, minimal little pubic hair, and testicular volume <2 cc. Ultrasound examination showed no presence of testes in the right or left scrotum fossa, inguinal, and lumbar region. Chromosome analysis showed 46 XY, and hormones analysis found FSH, LH, and testosterone below the normal limit. The patient was given 2000 unit HCG injection and after that FSH, LH, and testosterone hormone increase compared before HCG injections.

Conclusion: HH can impair physical and psychological patient’s quality of life through delays in sexual maturation and bone maturation. Strategies to recognize symptoms in early childhood and puberty induction on time can significantly improve the sexual and reproductive function of HH patients.

The short-term disadvantageous of tension-suture and spica cast application in exstrophy-epispadias complex reconstruction: a case report

Background: Exstrophy-epispadias complex (EEC) represents a spectrum of genitourinary malformations and associated with another congenital anomaly. EEC is a rare congenital disability. EEC affects the genitourinary system, anterior abdominal wall, musculoskeletal system, spine and anus. The surgical outcome has a lot of potential complications in patient with EEC. The decision to first approach is important for the next step. Herein, we reported a case of EEC with several anomalies.

Case Description: A new-born male was born with section cesarean at 38 weeks of gestation from 34-year-old mother, and this is from the second pregnancy. The weight was 3300 grams, and the height was 48 centimetres. There was an abdominal wall defect with an exposed evaginated bladder plate with urine draining from the defect. A complete dorsally opened urethral plate was seen from the bladder neck down to the glandular grove. The patient was diagnosed with Exstrophy-epispadias complex (EEC). A 2 stage repair was conducted in this patient. After 10 days post-operation, the wound became dehiscence and got sepsis postoperatively as well as lead to die in the day 20.

Conclusion: Wound dehiscence following reconstruction is very critical inpatient with EEC. Tension suture and spica cast application can be disadvantageous inpatient with EEC.